论文部分内容阅读
甲硝唑(Metronidazole)是应用较久的高效抗阿米巴、滴虫、厌氧菌药,近年来其应用范围日渐扩大,并取得较好疗效.本文略述该药在消化系统疾病中的应用.1 用于幽门螺杆菌(HP)相关性胃炎和消化性溃疡HP是非自身免疫性慢性胃炎的病原菌,是消化性溃疡多因素发病机制中的主要致病因素.甲硝唑对HP有抗菌作用,但单独使用极易产生抗药性,也易复发.由此第九届世界胃肠病大会推荐了一个三联2wk的治疗方案:甲硝唑400mg,每日3次;胶态次枸橼酸铋120mg,羟氨苄青霉素或四环素500mg,每日4次.该方案对HP的清除率高达80%.2 用于克隆病(CD)甲硝唑对结肠CD,特别是肛周病变或瘘管形成者有效.其药理作用可能是抑制肠道厌氧菌,明显改善肠粘膜,降低肠炎活动指数.目前仅作为治疗该病的第二线药物,在皮质类固醇类或水杨酸偶氮磺胺吡啶等无效时考虑使用.3 用于抗生素相关性腹泻 随着抗生素广泛使用,抗生素相关性腹泻也日益增多并受到重视.现已证明难辨梭状芽胞杆菌是本病的主要致病菌,该菌对甲硝唑非常敏感,其效果相当于本病的首选药——万古霉素.用法0.4
Metronidazole is a highly active anti-amoebic, trichomonad, and anaerobic bacterium that has been used for a long time, and its application scope has been expanded and achieved good efficacy in recent years.This article outlines the drug’s application in digestive diseases Application .1 for Helicobacter pylori (HP) -related gastritis and peptic ulcer HP is the non-autoimmune chronic gastritis pathogens, is the main causative factor in the pathogenesis of peptic ulcer multifactorial metronidazole antibacterial to HP Role, but it is easy to produce drug resistance alone, but also easy to relapse.Therefore, the Ninth World Gastroenterology Conference recommended a triple 2wk treatment: metronidazole 400mg, 3 times a day; colloidal citric acid Bismuth 120mg, amoxicillin or tetracycline 500mg, 4 times a day.The regimen of HP clearance up to 80% .2 for the colon disease (CD) metronidazole on colon CD, especially perianal lesions or fistula formation Effective pharmacological effects may be inhibition of intestinal anaerobic bacteria, significantly improve the intestinal mucosa, lower enteritis activity index currently only as a second-line treatment of the disease, corticosteroids or salicylazosulfapyridine and other ineffective Consider using .3 for antibiotic-associated diarrhea Antibiotics are widely used, antibiotic-associated diarrhea is also increasing and attention has been proved Clostridium difficile is the main pathogen of the disease, the bacteria is very sensitive to metronidazole, the effect is equivalent to the preferred disease Drug - vancomycin. Usage 0.4